TOXINS AND ANTITOXINS 289 



Mening-ococcus Meningitis. — Meningitis is an iniiammation of 

 tiie meninges or eoverings of the brain and spinal eord. While it 

 may be caused by various species of pathogenic bacteria, serum 

 therapy is of value only when the meningococcus is the causal 

 agent. In every case of suspected meningitis, spinal fluid should 

 be obtained and examined as early as possible since, if the meningo- 

 coccus is found, quarantine can be established and specific poly- 

 valent antimeningococcus immune serum administered as a thera- 

 peutic agent. While there are a great many papers appearing 

 relative to meningococcus toxins, there is no definite evidence 

 that the meningococcus produces a true soluble exotoxin. Flexner 

 (1906) developed the serum treatment of meningococcus menin- 

 gitis. He and others have shown that when serum containing 

 antibodies for the strain of meningococcus present in any par- 

 ticular epidemic is used, the mortalitj^ is reduced from 70 per 

 cent in untreated cases to 25 or 30 per cent in those receiving 

 adequate and early treatment with specific serum. 



Cellular Response Due to Serum. — Occasionally a physician 

 is called as a consultant in a case of suspected meningitis that has 

 received antimeningococcus serum intraspinally before the spinal 

 fluid was examined. The question arises as to the effect of the 

 injected serum upon the cell count of the spinal fluid. Very 

 little has appeared in the literature bearing upon this subject, 

 l^uryea (1930) studied the reaction in two normal individuals to 

 the intraspinal injection of 20 c.c. of concentrated serum prepara- 

 tions. A corresponding amount of spinal fluid was withdrawn 

 befoi'e the injections were given. Before treatment the cell 

 count in one volunteer was four and in the other two cells per 

 cubic millimeter. Within one hour the counts were increased to 

 3,800 and 4,640 per cubic millimeter respectively. At the end of 

 twenty hours the cell count of the first was 180 and of the second 

 300 per cubic millimeter. Both neutrophiles and mononuclear 

 cells were increased. Such phenomena should be borne in mind 

 in interpreting the laboratory findings in treated cases. 



Use of Serum in Virus Diseases. — Convalescent serum is em- 

 ployed frequently in the prevention and treatment of measles 

 and aLso in the treatment of poliomyelitis. It is very important 

 that serum of any kind intended for such purposes be sterile. A 



